Colorado Insurance Regulations: Rebates, Commissioner Duties, Fund Commingling, and Claims, Exams of Public Health

Download Colorado Insurance Regulations: Rebates, Commissioner Duties, Fund Commingling, and Claims and more Exams Public Health in PDF only on Docsity! Colorado Accident & Health Laws State Exam Simulator 100% Correct Which of the following is an example of defamation? A brochure including an untrue statement regarding a competitor's ability to pay claims A truthful estimate of the dividends A pamphlet listing a competitor's financial rating A verbal statement of a competitor's complaint ratio - A brochure including an untrue statement regarding a competitor's ability to pay claims Which of the following is an example of rebating? offer of temporary insurance coverage cancellation of an insurance policy without cause sale of mass-marketed insurance products returning a portion of a premium as inducement to purchase insurance - returning a portion of a premium as inducement to purchase insurance Which of the following is a duty of the Commissioner? Setting insurance rates Writing insurance laws Setting sales quotas Reviewing and approving license applications - reviewing and approving license applications A license is deemed to be used for controlled business if during any 12-month period the licensee wrote more than 10 policies on controlled business the licensee wrote policies totaling more than $25,000 on controlled business the licensee's total premiums on controlled business made up more than 25% of his total premiums the licensee's total premiums on controlled business exceeded the total premiums on all other business - the licensee's total premiums on controlled business exceeded the total premiums on all other business In Colorado, which of the following is true regarding the commingling of an insured's funds with the funds of the producer? It is never okay It is okay with the insurer's written approval It is okay if records are kept on the transaction It is okay with the insured's written approval - it is never okay Who is not eligible to receive commissions from the sale of an insurance product? Corporate executive General agent Licensed home office employee Personal producer - corporate executive Which of the following is an example of a misrepresentation? Making malicious statements about an insurer Describing a universal life policy as a security Returning a portion of a premium as inducement to purchase insurance Failing to affirm or deny coverage of claims within a reasonable time - describing a universal life policy as a security An insurer that terminates a producer's appointment must inform the Commissioner within how many days? 45 55 15 30 - 30 In Colorado, all of the following are considered unfair trade practices EXCEPT coercion rebating replacement misrepresentation - replacement A fiduciary responsibility is defined as a relationship of special trust and confidence when a person is entrusted with another's funds the responsibility of the insured to pay premiums in a timely fashion the responsibility the producer has to the appointing insurer the relationship between the broker and the insurer whose products are sold - a relationship of special trust and confidence when a person is entrusted with another's funds Circulation of a maliciously critical statement about an insurer's financial condition meant to damage the insurer's reputation or business is called defamation unfair discrimination conservation coercion - defamation Which information is NOT included in the Colorado Supplement to the Summary of Benefits and Coverage form? Covered cancer screenings Deductibles Insurer's prior year financials Balanced billing - insurer's prior year financials converting a term life policy to a whole life policy selling with a nonresident license misrepresentation - misrepresentation If a producer chooses to conduct business under an assumed name, when must notification be given to the Commissioner? No notice is required At the time of license renewal No later than 30 days after using the assumed name Prior to using the assumed name - prior to using the assumed name Paying insurance premiums on a more frequent basis will cause the policy to have lower premiums graded premiums average premiums higher premiums - higher premiums A verbal or written statement which misleads a policy's features, benefits, or coverage is considered coercion rebating misrepresentation defamation - misrepresentation Upon request, when must the Colorado Supplement to the Summary of Benefits and Coverage Form be provided? Within 30 business days Within 7 business days Within 15 business days Within 10 business days - within 7 business days Which of the following is NOT required to be disclosed to an applicant for health insurance? Any change to the standard compensation Standard compensation schedule for the product being sold Any contingent compensation received The insurance producer will receive a commission from the carrier - Any contingent compensation received In regards to maternity care, which of the following is not required to be covered in the State of Colorado? Standard newborn circumcision Injuries or sickness Congenital defects Birth abnormalities - standard newborn circumcision In Colorado, what is required to be covered in individual and group medical expense policies? Epilepsy Accidental death In vitro fertilization Diabetes - diabetes Which of the following is NOT a required provision for an accident and health policy? Insurance with other insurers Reinstatement Grace period Incontestable - insurance with other insurers A health insurer may exclude medical coverage for any claims that result from skydiving snow-skiing off-highway vehicle riding snowmobiling - skydiving T calls to file a claim on his health insurance policy. Within how many days must the insurer provide T's proof of loss forms? 15 days 20 days 10 days 30 days - 15 days When an employee's coverage terminates under a group health policy, the employee must be offered continuation coverage for 18 months 180 days 60 days 365 days - 18 months Which of the following coverage exclusions or limitations is permitted under a long- term care policy issued in Colorado? Alzheimer's disease Preexisting conditions Senile dementia Parkinson's disease - pre-existing conditions All accident and health policies issued in Colorado that provide major medical services must offer policyholders the opportunity to purchase supplemental coverage home health care coverage double indemnity coverage disability coverage - home health care coverage The primary difference between the Colorado Partnership LTC policy and other LTC policies is longer lifetime benefits Medicaid asset protection higher daily benefits optional inflation protection - medical asset protection An insurer can deny a claim under a long-term care insurance policy for any material misrepresentation made by the insured if it has been in effect for fewer than 6 months no more than 2 years at least 1 year more than 6 months - fewer than 6 months Which of the following documents are NOT required to mention the Colorado Fraud Statute? Claim forms Certificates of authority Policies Applications - certificates of authority If an insurer is authorized to conduct business in another state and wishes to conduct business in Colorado, it must receive a certificate of authority from the Federal government receive a certificate of authority from a reciprocal state receive a certificate of authority from Colorado receive a certificate of authority from a bordering state - receive a certificate of authority from Colorado Licensing is required for all of the following EXCEPT travel ticket selling selling prepaid legal services limited lines credit surplus lines - selling prepaid legal services When may the Commissioner issue an emergency cease and desist order? If there is suspicion of an unauthorized person engaging in insurance business without being licensed When an insurance agency does not reach their annual sales quota For any reason the Commissioner sees appropriate If there is suspicion of an insurance policy being replaced - If there is suspicion of an unauthorized person engaging in insurance business without being license What is the maximum amount the Commissioner can fine an insurer for each violation of a cease and desist order?